Congressional Record, Volume 157 Issue 2 (Thursday, January 6, 2011)

[Congressional Record Volume 157, Number 2 (Thursday, January 6, 2011)]
[House]
[Pages H82-H88]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

REPEAL OF THE AFFORDABLE HEALTH CARE ACT

The SPEAKER pro tempore. Under the Speaker's announced policy of
January 5, 2011, the gentleman from California (Mr. Garamendi) is
recognized for 60 minutes as the designee of the minority leader.
Mr. GARAMENDI. Madam Speaker, it's a great privilege to be here on
the floor with you. Congratulations to you and the other new Members of
the Republican Party.
We have some extraordinarily important tasks ahead of us. This
afternoon, I'm going to be joined by some of my colleagues. We've just
heard a very useful discussion on the role of the Constitution and how
it plays into it. And indeed, today we did spend about 3 hours reading
through the Constitution, and I think it was to all of our benefit. We
started off with the new Speaker actually reading the preamble. I think
that's a good place for us to start, because we're going to discuss
health care today and we're going to discuss an effort by the majority
party, the Republicans, to repeal the Affordable Health Care Act that
was passed last session. And this issue has become a constitutional
issue, so reading the preamble to the Constitution and Article I,
section 8 is useful.
``We the people of the United States, in order to form a more perfect
Union, establish justice, insure domestic tranquility, provide for the
common defense, promote the general welfare''--promote the general
welfare--``and secure the blessings of liberty to ourselves and our
posterity, do ordain and establish this Constitution for the United
States.'' And then later, in article I, section 8, ``Congress shall
have power to lay and collect taxes, duties, imposts and excises, to
pay the debts and provide for the common defense and general welfare of
the United States.''
It's about the general welfare of the United States that we'll be
discussing in this next hour, and that's the welfare of the people of
the United States. It speaks to us, the citizens--all of us--whether we
are a newborn baby or a senior in the last of life--how do we provide
for that general welfare?
Last year, in a major step forward, the first time in more than
nearly four decades, this Congress, together with the Senate and the
President, passed the Affordable Health Care Act, a very, very
important and extremely useful step in providing for the welfare--that
is, the general welfare--of the American population. It's a law that
makes life better from birth to retirement. Part of this law, a very,
very important part of it, deals with what we call the Patient's Bill
of Rights--the Patient's Bill of Rights, vis-a-vis, the insurance
industry.
I think all of us can go back to our districts, to our homes, and
even to our own lives and find numerous episodes where the insurance
industry has said, No, you cannot have this procedure; or, No, you
cannot have coverage because you have a preexisting condition.

{time} 1540

Today, we are going to talk about the Patients' Bill of Rights and
the Republican effort that is now underway in the Rules Committee in
this building, as we speak, to write a rule that they will bring to the
floor next week, without one hearing, to completely wipe out this
extraordinarily important effort to provide for the general welfare of
the American people. We are going to discuss that in great detail.
Now, for me, this is a very important part of my life. I spent 8
years of my life as the insurance commissioner in California, taking on
the insurance companies, trying to force them to honor their
commitments, to force the insurance companies to pay the claim of a
patient who had undergone chemotherapy, to provide insurance that was
contracted for and not to rescind that health care policy. I cannot
even begin to count the number of cases that came before me as
insurance commissioner where the insurance companies would rescind a
policy because the person suddenly became ill and had a very expensive
episode.
The Patients' Bill of Rights prohibits that. We are going to talk
about that. I want to start here, and then I'm going to turn this over
to my colleagues.
I am going to give an example of a very dear friend who lived here in
Washington. He was a Peace Corps volunteer, married. He was working
here in Washington, DC, as the director of the National Peace Corps
Association, the returned volunteers. He had a child. That child had a
severe disability--kidneys didn't work. He was insured. His wife was
insured. The pregnancy was insured. The delivery was insured. But that
child, on the day the child was born with that preexisting condition of
kidney failure, was uninsurable under the parents' policy.
That kind of action is prohibited by the Patients' Bill of Rights. No
more would that happen to men and women, families, pregnant women
across this country who deliver babies that have some problem. Those
babies will be insured whatever the condition might be.
Our colleagues on the Republican side will bring to this floor next
Wednesday, without one hearing in any relevant policy committee, a
repeal of the Patients' Bill of Rights. What of the babies that are
born in the future that have some issue? How will they be provided for?
The rest of the story is this family has spent 20 years now
struggling to provide the health care services that their child needed.
They have been close to bankruptcy many, many times. They have
struggled through it. The child is no longer a child--a young adult--
and under the law today, he has health insurance.
Is that what the American public wants from the Republican Party--the

[[Page H83]]

repeal of that Bill of Rights that guarantees coverage for that young
man? I think not.
Let me now turn to our colleague from the great State of Virginia.
Bobby Scott, would you please share with us your own views and how
this is going to affect the general welfare of the American people.
Mr. SCOTT of Virginia. Thank you, and I appreciate your hard work.
Thank you for organizing this Special Order so we can discuss the
problems with repealing health care.
You have gone all through the need for health care during your life
and how the bill provides assistance for those with preexisting
conditions. It limits insurance company abuses, like what's called a
``recision,'' when you have paid your premiums all these years and then
finally get sick, and they want to cancel your policy right when you
need it. There are lifetime and annual limits on benefits where they
pay a certain amount, and once they get to that, you can be in the
middle of a treatment, and they're not going to pay another dime for
the rest of your life or at least for the rest of that year. There are
many people with chronic diseases who hit up upon these limits very
frequently.
You have talked about young people on their parents' policies, who
are working, who finally get jobs. They don't cover benefits. Up to 26
years old, they can stay on their parents' policies.
We have talked about prevention, the importance of prevention. A lot
of people, because of copayments and deductibles, can't afford their
annual checkups. This bill provides for annual checkups without
copayments and deductibles.
For those senior citizens in the doughnut hole, where they get no
benefits, adding insult to injury, they have to continue paying their
premiums, and get no benefit. We have assistance for them.
It is outrageous that they would elect to try to repeal this. No
hearings. No nothing. Just put a label on it and call it ``ObamaCare''
and then expect people to go along with the repeal. You just can't
label things and expect people, by virtue of the label, to take action.
They call it ``government-run health care.'' No. Government-run health
care was the single-payer plan. That was defeated.

The option of a public option would have been nice. People talk about
choice. Well, in the plan that's on the books today, they have the
choice of all the plans of anybody who wants to sell insurance in their
States. They have a choice of all of them. It would be nice to have an
additional choice--a choice of a public option where you have the
choice of a policy that is not run by a for-profit corporation with a
financial interest in denying you coverage or canceling your policy. It
would be nice to have that option. You don't have to pick it, but it's
just nice to have that option.
One of the things that we want to make sure is that we have as many
options as possible, including a public option if we can ever get
there; but when we talk about repeal and replace, there is no replace
tomorrow in the rule that they are suggesting. They just want it
repealed. We want to know what they're going to replace it with and
what they're going to leave out.
Are they going to leave out the part where people with preexisting
conditions can get covered? Are they going to say, ``No, you can't get
covered''? Does the insurance company get to decide who has the
privilege? Are health insurance companies going to tell young people
under 26 to get off their parents' policies? Are they going to tell
those in the doughnut hole to get back in the doughnut hole where they
belong? Are they going to talk about those who can't afford prevention
to get prevention? Are they going to tell those who are going to run
out of coverage because of the limits, ``No, that's enough. You've had
enough, and you can't get any more coverage''?
What are they going to tell all of these people?
We need to make sure that we keep this policy, all of these
provisions, intact. I have no idea what they want to replace it with,
but I think, if they went step by step and if the people looked at the
provisions of the bill, they would elect to keep everything that's in
the bill today.
Now, there are some things that people don't like. When you have a
good plan, you have to pay for it. Unfortunately, they're not paying
for it. We were fiscally responsible. When we passed it, we were under
PAYGO. They've repealed a lot of that so that they can go trillions of
dollars in the ditch without paying for it. We paid for it. In fact,
the CBO originally said that the first 10 years of the program would
reduce the deficit by $140 billion. Now the estimate is $200-some
billion in the next 10 years. So it is fiscally responsible.
There are things we can do better together than everybody out for
their own. We need to oppose the repeal of this health care to make
sure that people have the protections and the Patients' Bill of Rights
that they have under this legislation.
Mr. GARAMENDI. Thank you very much.
You've raised about seven of the major issues that are involved in
this repeal that the Republicans will bring to this floor next
Wednesday without one hearing in any relevant policy committee, a
repeal that will affect every single American--that will affect their
well-being, their health, their ability to get health insurance, and
their ability to stay healthy.

{time} 1550

So we have an enormous issue before us and we want the American
public to be aware of what's going on here. It is the repeal of the
Patient's Bill of Rights.
Let me move on to one of our other colleagues from Tennessee. Mr.
Steven Cohen, if you will join us, please.
Mr. COHEN. Thank you. I appreciate the opportunity to share with you,
and I want to first start because this day has been a day that started
with the reading of the Constitution which is a document that we all
revere. I have a little pocket copy of it right here, and we revere it.
We pledge when we take our oath of office to protect and defend and
support the Constitution, but we all know that it's interpreted by our
Supreme Court, and it's Supreme Court history would have been better
today for people to understand.
And you mention that the foundation of the particular health care
bill is in the preamble: We, the people of the United States, to form a
more perfect union, establish justice, et cetera, promote the general
welfare.
Also, in article I, which is the legislative article, section 8, it
says that the Congress shall have the power to regulate commerce among
the several States; and further, it says in article I that the Congress
shall have the authority to make all laws which shall be necessary and
proper for carrying into execution the foregoing powers and all other
powers vested by this Constitution of the Government of the United
States, in either Department or office thereof. So, in my opinion--I'm
a lawyer, but there's lawyers on both sides--there's plenty of
justification for this health care bill.
Do you know next week when the Republicans will try to repeal this
opportunity for Americans to get health care and wipe out these pre-
existing conditions clauses, et cetera, will they be coming under the
idea that health care is not part of the general welfare? Will they be
coming basically on a constitutional argument that they may make that
this wasn't allowed to require a person to buy insurance even though we
can, of course, require a person to sign up for the draft and lose
their liberty for a while and serve in the Army--and we can do that, we
can conscript soldiers, but we can't make them buy insurance. Is that
what they're going to say, or are they going to come and talk about
these things that Mr. Scott talked about and say that we don't think
it's good policy for parents to have their children on their insurance
until they're 26 or it's not good policy for women with breast cancer
to get treatment at a certain amount? What are their tactics?
Mr. GARAMENDI. Well, I would assume that they will try to go into
their interpretation of the Constitution and avoid the very difficult
argument of forcing or eliminating the Patient's Bill of Rights and
allowing the insurance companies to engage in gross discrimination
based upon sex. Clearly, women are discriminated against by the health
insurance companies unless the Patient's Bill of Rights is there to
protect them. Similarly, the two examples that you gave, pre-existing
conditions, I cannot imagine that they

[[Page H84]]

would even attempt to successfully or even would be unsuccessful to
argue that somehow these protections for the individual are not worth
having.
I think they will go into some obscure interpretation of the
Constitution. We'll see. There's going to be a debate on the floor.
Unfortunately, there will be no hearings to precede that, and there
will not be a discussion of the details.
Mr. COHEN. And they will control the amendments that will be
permitted to be discussed on this floor. I know Speaker Boehner said we
were going to be able to have amendments and be able to have good
discourse.
Mr. GARAMENDI. As you know--I saw you in Rules Committee earlier
today--it is my impression that the Rules Committee is going to
prohibit any amendments on the floor. We'll see. I mean, that has yet
to be decided by the Rules Committee. We don't know, but surely the one
amendment I would propose is: don't do it, maintain the Patient's Bill
of Rights, maintain these protections that we all need.
There's not a person in this Nation that is not subject to the
possibility of an incident that would become a reason for rescission.
That's my experience. Eight years hammering the insurance industry, you
have got to honor your contract. Yet because of the laws, they were
able to wiggle out of an expensive incident.
Mr. COHEN. When I was a child, I had polio when I was 5 years old in
1954. I was fortunate. My father was a doctor, and so sometimes
professional courtesy, but I'm sure he had insurance that covered my
hospitalization. But there were years later, I think it was 11 years
later I had a tendon-lengthening operation that was immediately related
to my polio and necessary on my Achilles tendon. That wouldn't have
been permitted necessarily if they could use the pre-existing condition
such as polio to have denied coverage; and whether or not how my father
dealt with the expense and whether it's because he was a physician, I
don't know; but I'd hate to see children in the same situation and
parents in the same situation not be permitted to get that type of
coverage later on.
Mr. GARAMENDI. I don't know if you were a Member of Congress at the
time, but we all under this law would have the same policy that every
American would have. We wouldn't have any different policy than the
American public would have, and the question about rescission, and
you're a prime candidate should you lose office, which you shouldn't,
to be uninsurable if the Patient's Bill of Rights were repealed.
Under the Patient's Bill of Rights, if you were to leave Congress,
you could get an insurance policy because the pre-existing condition
that you have, polio, and an operation resulting from the polio would
go into play as a pre-existing condition, and you would not be able to
get an insurance policy.
Mr. COHEN. Let me, if I can, read something that I've had prepared
for today that came from a constituent's story, John Hopkins; and I
know John Hopkins. He's a very important and active member in
my community and contemporary. He sent me an email, and Mr. Hopkins
requests I share this story with the House as we consider repeal of the
Affordable Care Act. I want to share it with everybody here on C-SPAN.

John was diagnosed with two unrelated cancers during his life. If you
know anything about cancer, getting it twice for unrelated reasons is
almost unheard of, but it happened to John Hopkins. Midway through his
first bout with cancer, he was, of course, dropped from his health
insurance plan. He was left with a medical bill that wiped out his and
his wife's entire retirement savings, as well as the value of their
house. They were never able to repay the debt in their lifetime. When
he was diagnosed with a second bout of cancer 2 years later, he had no
health insurance because there was no insurer anywhere in the market
who would offer him a policy because of the pre-existing condition.
He got some coverage in Tennessee because of a plan called Access
Tennessee for uninsurables, but it was limited to $250,000 a year. As
we all know, annual limits are set to be phased out by 2014 because of
this law, and lifetime limits are already a thing of the past. A
quarter of a million dollars may seem like a lot of coverage; but when
somebody needs something like a bone marrow transplant to cure their
leukemia, that single treatment would exceed the annual cap.
My Republican colleagues have decided their first priority as the new
majority will be repealing the Affordable Care Act; and when they vote
to do this, they will be voting for the following: denying Mr. Hopkins
the ability to enroll in a health insurance plan that doesn't
discriminate against him for daring to be diagnosed with cancer again.
They will deny John Hopkins the ability to enroll in a health plan that
will actually continue to cover his treatment after he exhausts the
current annual cap of $250,000, an amount that many cancer patients
meet in a matter of weeks upon diagnosis, let alone those who are
fighting two cancers over a number of years.
And it will send a message to John Hopkins and every other single
American who has ever been diagnosed or will ever be diagnosed with a
disease like cancer that they're on their own when it comes to
coverage, that sure they're free to get treatments and meet with their
doctors, undergo laborious and life-saving surgeries year after year,
just so long as they can foot the bill or try to keep it under the
annual cap, because when it comes to cancer, budgeting your treatment
should surely take precedence over anything else. Right?
Mr. Garamendi, I am ashamed that we are considering repeal of this
affordable health care bill; and when I see these numbers about
$250,000 and I think of the fact that the Republicans were against any
caps on taxes, they realize $250,000 annual income in many places is a
middle-income salary, but for limitations on health care, they think
the insurance company should determine that and that's enough; and if
you have got cancer, it's not enough.
Another friend of mine Facebooked me, Jimmy Barrasso. Jimmy worked
for a long time for a company in Memphis. He's always been successful.
He lost his job with that corporation. Because he had high cholesterol,
he had difficulties getting insurance, and it took him a long time to
find private insurance because of that pre-existing condition. He just
sent me this on Facebook. He was friending me and he mentioned it, and
I wanted to relate it.
There are so many people in this country who are getting benefits and
will get benefits and many of the benefits don't go into effect until
2014, and the idea that this Congress, the 112th, as its first act
would do such harm to the general welfare of the American public is
hard to fathom.

{time} 1600

Mr. GARAMENDI. Mr. Cohen, thank you so very much. Your closing
sentence needs to be repeated. That the very first piece of legislation
taken up by the new Republican majority in the 112th Congress is to
repeal the Patients Bill of Rights. It's unfathomable.
Let me now call on Frank Pallone, our colleague from the great State
of--yes, it is--New Jersey.
Mr. PALLONE. Well, first of all, let me thank you, my colleague from
California, and each of the other speakers here for the contribution
they have made tonight, and particularly when I listened to my
colleague from Tennessee talk about those particular cases of
individuals that were impacted, because that's really what this is all
about.
Again, it is amazing to me that the first act of this new Republican
majority is to try to repeal a bill, health care reform, that really is
making a difference for people on a personal level, particularly with
the patient protections.
You know, I thought to myself when I was coming down here: Who
benefits from repeal? Who could possibly benefit from repeal? Because,
as many of you talked about, all the people who are going to be harmed
by it, who would benefit from it? And the only group I could think of
that would benefit from the repeal are the big insurance companies
because, if you think about it, what do they want to do? They want to
keep increasing premiums. I read that in your State--I don't know, you
may have already mentioned it--Blue Cross/Blue Shield, whatever, is
talking about a 50-something percent increase. I cannot fathom these
double-digit increases.
And, of course, as this health care reform kicks in, it's going to be
more and

[[Page H85]]

more difficult for the types of increases that we've seen in premiums
that these big health insurance companies have put forward. And the
reason the insurance companies want to get rid of the Patients' Bill of
Rights and reinstitute all of these discriminatory practices, whether
it be denying care because of preexisting conditions or reinstituting
lifetime caps or, you know, the different protections that we've seen
kick in, the reason they want to do that is also money-oriented. In
other words, they have to pay out money. You talked about the cancer
person.
I was up at the Rules Committee earlier, and Ms. Slaughter was
talking about someone who had cancer and was treated and ran into the
lifetime cap, and then the cancer reoccurred and she didn't have any
more coverage because she had hit the lifetime cap. And that's a
perfect example. They want to have lifetime caps. They want to have
annual caps. They don't want preexisting conditions. They don't want
your kids on your policy because it saves them money. The way that they
make profits and pay dividends to their shareholders is by raising
premiums and having discriminatory practices that eliminate the people
that cost money because they need health care. I mean, it's that
simple.
And already, and just in the last few weeks, provisions have kicked
in that go against that. The President announced--or the White House
announced, I think around Christmastime, new regulations that say that
any premium increase that's over 10 percent will be scrutinized. And
under the provisions of this bill and the new regulations, these
increases are not allowed to go above 10 percent. On January 1, the
provisions kicked in that said that 80 percent of your premium costs
had to be used for benefits, couldn't be used for insurance company
profits, couldn't be used to pay back dividends to the shareholders. So
all of these initiatives that are already kicking in, they basically
make it more difficult for the insurance companies to make a big
profit, and the consequence of that is that health insurance becomes
more affordable.
I was up at the Rules Committee earlier. It was interesting because,
I think you mentioned, my colleague from California, or one of you
mentioned that we, under this bill, under the health care reform that's
in place now that they want to repeal, we get the same health
insurance, as Congressmen, as any other American.
You know, I still have people write to me and say, well, you know,
You have your own policy, but you want to give me this lousy coverage
that I'm going to get under the health care reform. And I have to write
back and say, No, that's not true. You may hear that on some TV station
or something, but it's simply not true.
We specifically wrote into the bill that we have to go into the
exchanges just like everybody else. We are going to be different from
other Federal employees, as Congressmen, because we go into the
exchanges.
So, at the Rules Committee today, one of the Republican Members who
is very supportive of repeal said that he specifically wasn't going to
take health insurance as a Congressman, and he wanted me to know that
because he was voting for repeal. And I said, Well, that's very nice
and that's commendable for you, but I, frankly, think that every Member
of Congress who votes for repeal should say, I don't want health
insurance from the Federal Government, because if you are going to deny
it to everyone else, you should deny it to yourself. Just the way we're
saying that we are going to get the same coverage as everyone else,
well, if you don't want anyone else to have the coverage, then you
shouldn't get it yourself.
And I know that some Members have already taken issue. There was one
Member from Maryland who came to the orientation, a Republican Member
from Maryland who apparently was a big advocate for repeal. And he said
that he was inquiring because his Federal health insurance didn't take
effect, as a Congressman, until February 1. We were sworn in yesterday,
but I guess it takes 30 days before the insurance actually kicks in. He
was complaining about the fact that had he to wait until February 1 to
get his health insurance, as a Congressman. Well, you know, again, if
you're going to vote for repeal next week, you shouldn't be worried
about when it's going to kick in. You shouldn't be taking it at all, in
my opinion.
So there is a lot of--I don't know what the phrase is--smoke and
mirrors or whatever the word is that is going on around here on the
other side of the aisle in how they are viewing this. And my point is,
you know, there is a lot of protection here for people. Don't deny them
that unless you're going to deny it to yourself. But more than that,
think about who is helped by this repeal--only the big insurance
companies. They are the only ones that are going to benefit.

I know you were the insurance commissioner, and so you know exactly
what I'm talking about.
Mr. GARAMENDI. I do have some experience on that. I wanted to deal
with that. It's called the medical loss ratio, and the insurance
companies have cut a fat check for themselves over the years by taking
a big premium and then paying a very small amount of it out for the
medical coverages.
In this legislation, the Patients' Bill of Rights, and in the
Affordable Health Care Act, they can't do that. They've got to pay, for
the individual policies, 80 percent and, for the group policies, 85
percent for medical services.
So what was the very first thing they did after this bill was signed
into law? We passed it last year, and the President signed it. The very
first thing they did was to run down to the Health and Human Services
Department and say, Oh, but our advertising ought to be included as a
medical expense, and, Oh, these expenses for these kinds of employees,
mostly statisticians and the like, that's a medical expense.
Fortunately, the administration said, No, we think not.
So what we're trying to do with this legislation is make sure that
when we pay a dollar, at least we get 80 cents back in medical
services. Our friends on the other side would repeal that and allow the
insurance companies to take that money--or at least a larger portion of
that money--put it in their pockets, give it to their CEOs, whatever,
but not use it for medical services. Medical loss ratio is really
important.
And the other thing you mentioned needs to be understood also, and
that is the ability of the governments to review, not to say ``no,''
but to shine that big, bright spotlight onto the insurance company
premium increases. Is it justified? Yes? No? What are your costs and so
forth? What ratios are you using in medical losses and the like? So
that spotlight of information is required under the law. Many, many
things in the law.
Mr. Cohen, I see you stood up, anxious to make a comment here, so
please do. And then I notice behind you our colleague from Maryland has
joined us. And eventually, I want to start talking about seniors. So
please, Mr. Cohen, go forth.
Mr. COHEN. I wanted to ask you a question. Because I had said, and I
was, I think, incorrect, when I suggested that the first thing the
Republicans wanted to do was repeal the affordable health care bill.
It's one of their first major priorities. But the first thing they did
was today, and we joined with them. It was bipartisan. It was to cut 5
percent from our Members' representational allowances, a small amount
of money in the big picture, of course. But the deficit was the issue
that they were highlighting.
What would the repeal of the Affordable Health Care Act do to the
deficit? That's the big issue, because that's one of our big issues.
Mr. GARAMENDI. Well, Mr. Cohen, it just happens that we prepared this
little blue chart here. Actually, it probably ought to be in the red.
The repeal of the Affordable Health Care Act obviously deals with the
Patients' Bill of Rights, but it also deals with the deficit.

{time} 1610

This week, the Congressional Budget Office, nonpartisan, not
Democrat, not Republican, they answer to neither party. They answer to
the general public. They said that the repeal of the Affordable Health
Care Act will increase the deficit by $230 billion, $230 billion in the
next 9 years, and in the out years, the next 10 years, well over 1
trillion, $200 billion increase in the deficit.

[[Page H86]]

Mr. COHEN. And that's money we owe China; is that right? So it's okay
to issue these securities and pay the Chinese the interest to be able
to finance it, and our children and their grandchildren will be paying
this if they don't have preexisting conditions where they can get
insurance to cover the illnesses they may have to stay alive to pay
these taxes.
Mr. GARAMENDI. Our children, grandchildren, and indeed those of us
that are living for another 10 to 15, 20 years, we're going to pay
twice. We're going to pay the insurance cost, the health care cost
that's not covered by the insurance programs. The example you gave of
the individual with two bouts of cancer going to pay the full cost of
that because the limitation goes back into place, so you get to pay for
your health care, and you're going to have to pay off the deficit also,
makes no sense whatsoever. But, hey, that's what they want to do,
without one hearing by any of the relevant committees.
Mr. COHEN. Consistency is the hobgoblin. Right? Thank you, sir.
Mr. GARAMENDI. I notice that our colleague from Maryland has joined
us, Ms. Edwards, Ms. Donna Edwards. I know you were interested in this.
You were talking about it earlier today on the floor and in committee,
so please.
Ms. EDWARDS. I'm so pleased to join you today and to talk about
health care. And I feel very personally about health care, as somebody
who went for a long time without any health care coverage and worried
like Americans do all across this country. They did prior to our really
investing in reform for the American people. And so I know that
anxiety.
And I was thinking about some of our constituents, constituents in
Maryland's Fourth Congressional District, and around the country, who,
today because of what we did in the Democratic-led Congress in passing
landmark health care reform legislation, are better off today. And we
haven't even fully implemented the benefits for the American people.
I think about a letter that I got from a gentleman who lives in my
district in Olney, Maryland, a small town, Olney, Maryland. And he
writes to me that his son, Mike, was 25 going on 26, and he could
receive health care insurance coverage. When he wasn't able to get it,
he needed it and he couldn't get it. And he got a letter from Blue
Cross/Blue Shield saying to him that his son could continue to be
covered until his 26 birthday. And what he did was he did what a lot of
American families do, they're wiping the sweat from their brow because
they know that they can now keep their young people on their health
care plan until they're 26. I have a 22-year-old. I was feeling exactly
the same way.
I got another letter from a woman who actually does health care
policy, but she lives in my district; and what she said to me is that
her daughter had a preexisting condition and she was very concerned,
but she was an older young person, 20-some years old, 20 years old with
a preexisting condition, really worried that she wouldn't be able to
provide health care. And then she got the notice for COBRA coverage,
which we've all said, you know, the backup is COBRA. It turned out that
that was going to be an extra $400 to $500 a month for her to have
COBRA coverage to make sure that she didn't lose her health care when
she actually lost her job.
Well, now, this parent, actually, for the cost of about $70 or $80,
as opposed to $400 or $500 a month, can keep their young person, their
child, their young person on their health care coverage.
I think this is a great benefit for America's families, for families
who work every day and actually have health care coverage.
I heard us earlier discussing premium increase hikes, and I want to
tell you something. I know when we were working on health care reform,
and many of us, very concerned about people who don't have insurance
and need coverage. But most Americans all across the country actually
do have some form of health care coverage. And you know what they're
worried about? They're worried about those premiums going up at
astronomical rates. And I've heard from my constituents, 20, 30 percent
premium hikes.
Well, because of what we did in this health care package, insurance
commissioners, like you were a commissioner, insurance commissioners
all across the country now have the power vested in them to be able to
actually say, you know what? We're going to put a check on these
companies. And so in States like California, a big State like
California and Connecticut and Maine and Colorado and Maryland, all
across the country, that's what these insurance commissioners are
doing. And they're not saying the Feds do it for them; it's the States.
And of course we heard here this morning, as we read the
Constitution, a reminder that States are in a great position to look at
what insurance companies are doing in their States, to regulate what's
happening in their States, and to say to them, you have to stop taking
money away from consumers, away from patients by raising your premiums
excessively.
And so these are real accomplishments for the American people and for
people who go to work every day. And so I'm glad to be here actually
talking about these benefits with the American people.
Mr. GARAMENDI. Thank you so very, very much. Before I turn to our
colleague from Virginia, you reminded me of two very quick stories.
One, on Monday I was at the inaugural for the Governor of California.
Jerry Brown is back again. And a lobbyist that I knew when I was
insurance commissioner representing health insurance companies came up
to me and he put his finger in my chest and he said, don't let them
repeal the law. Now, I'm not going to give his name. He'd lose his job
immediately.

And I said, I'll do everything I can, but why? You represent them.
Why?
And he said, I have two children. Both are type 1 diabetics. They're
approaching 23 years of age. They will be out of luck. They will never
be able to get an insurance policy if this bill is repealed. The
Patient's Bill of Rights gives that lobbyist for the health insurance
industry an opportunity to see his children get health insurance.
Now, I have six children of my own. Patty and I do. All six of them
have gone through that age of 23. It is the scariest time for a parent.
You graduate, you get a diploma, and you also get an exit from the
insurance that you've had perhaps for your entire life. This law
provides another 3 years after you graduate, that period of time where
it's almost impossible nowadays to find a job that provides insurance
to give that insurance.
Mr. Scott, please join us once again.
Mr. SCOTT of Virginia. Thank you very much. And I appreciate your
hard work and leadership on this. You've talked about the problems in
health care with government. It's just not a government problem. If you
ask any human resources executive about the major problems they have
and benefits package, it's the ability to afford health care. Health
care costs are going out of control. If you have an employee with a
preexisting condition and he's in the group, then they do the actuarial
study, you start getting bills that you can't pay. You ask any human
resources what's happened to their insurance costs over the years. It's
just going through the sky. And if you look at the employee portion of
health care, it goes from zero participation to a little bit more
copays, more deductibles, more cost for the family, on and on and on.
Everyone has a great deal of insecurity about their ability to do
health care.
And then you look at the idea, what happens if you lose a job? If you
have a preexisting condition, you will not be able to get health care
until this bill passed.
With all this insecurity, your ability to get health care, your
ability to be able to afford it in the future, all of these problems,
all of these problems in the future, what is the response from the
other side about what to do about that kind of insecurity?
They say, well, just be strong and go without insurance like me.
Well, that is not a particularly attractive solution for those that
don't have an alternative, don't have a spouse where you can just jump,
you know, you can say I'm not going to take government policy, I'm
going to use my spouse's policy; we have an alternative. Or if they're
so wealthy, they don't need the insurance.

{time} 1620

Most Americans aren't in that situation. They need health insurance.
And

[[Page H87]]

this is what is provided. You have access to it, and it is affordable.
Everyone in America will be able to afford health insurance in 2014
because those that can't afford it will have subsidies to make sure
that they can. So everybody will be able to get it.
If you make less than $88,000, you can get health care for less than
10 percent of your salary. That is not the case now. If you are in the
$20,000, $40,000, $50,000 a year bracket, if you can get insurance,
it's going to be a lot more than that.
So with this bill people have the security of health insurance that
they don't have now. And the bizarre suggestion, just go without
insurance, is not particularly nice when you have children that may
have a little ear infection. Rather than have them lose their hearing,
you can deal with it when it is a little infection, these problems
don't grow out of control. We need that security. This bill provides
it.
And in terms of seniors, seniors are particularly helped under this
legislation. Those that can't afford the copays and deductibles can get
their annual checkups without any copays and deductibles. We are
helping fill in the doughnut hole. It will take a little time, but
eventually there will be no doughnut hole where they fall in and have
to pay all of the drug costs. We provide more community health centers
so they will have better access. We are training more doctors and
nurses so they will have more professionals. You have a chart that
extends Medicare. Medicare is extended. We know that Medicare will go
broke if we don't do anything. It extends the solvency of Medicare. It
lowers prescription drug costs. All of these things that seniors have a
particular interest in, all of that will be lost if this bill is
repealed.
Mr. GARAMENDI. If I might interrupt you for just a moment, Mr. Scott.
You are into an issue, an area that is profoundly important to the
seniors of America.
The discussion last year as this bill was passing was that somehow
this piece of legislation would harm seniors by taking away Medicare
benefits. It was not true last year. It is not true this year. However,
if our Republican colleagues are successful in repealing it, they, the
seniors, will be seriously harmed.
I want to make this point very, very clear and ask my colleagues to
join us perhaps from their own personal experience in their districts.
You started going through this list here. This legislation actually
extends the solvency of Medicare by reining in the costs and by giving
seniors specific pre-illness care so that they will be able to get
preventative care free, free annual checkups. They can't get it today,
but under this legislation seniors can get free annual checkups, which
reduces the cost, because you get to the illness quicker.
Mr. SCOTT of Virginia. You said that people were scared about what
might happen. They also said things about small business, this would
bankrupt small businesses.
First, small businesses are exempt from the requirements under the
bill, so it can't possibly hurt them. But those small businesses that
want to provide health care for their employees are given tax credits
to help them do so. So it can't possibly be hurting small business. But
for the senior citizens, they have all of the benefits that you have
listed on the chart that will be lost if this bill is repealed.
Mr. GARAMENDI. You mentioned the doughnut hole, the prescription drug
doughnut hole. Every senior that was in the prescription drug doughnut
hole last year, 2010, received a $250 check to help them pay for their
drugs. In going forward, the doughnut hole will be lessened and
lessened, and eventually, 9 years from now, will disappear. There will
be no doughnut hole.
You talked about the quality of care. Extremely important, quality of
care. Thank you for bringing that up. More primary doctors, more
geriatric care from nurses and doctors, an extraordinary important part
of the legislation, not just only for seniors. You also mentioned the
community-based and of course the preventative care. All of these
things are there, and all of them will disappear if the Republicans are
successful with their legislation next Wednesday that will be brought
to this floor without one hearing to discuss any of these issues in a
relevant policy committee.
Mr. Cohen, please join us.
Mr. COHEN. Let me ask a question. I was just thinking here, it's an
honor to be in the House of Representatives and with a Constitution
that's so beautiful that it says we are to promote the general welfare.
We are among other industrialized nations on this earth. What do the
other industrialized nations on the earth do about health care for
their citizens?
Mr. GARAMENDI. Well, I'm not sure I heard your question, so please
say it again.
Mr. COHEN. What do the other industrialized nations in the world do
for health care? Do they program policies like ours, where 32 million
people don't have health insurance reform and they are not mandated to
get insurance? What do they do?
Mr. GARAMENDI. Well, I think you are asking me a rhetorical question,
because you know the answer and I think most Americans know the answer,
that all the industrialized nations--we are not talking about China,
but we are talking about Korea, Japan, the European countries, the
European Union. All of those countries provide universal health
insurance coverage. Universal.
Everyone, including tourists who happen to show up--and this I know
from one of my daughters who fell off a stair at the Leaning Tower of
Pisa. She fell, went into an emergency room, they took an MRI, bandaged
her up, and said, ``Get out of here.'' And she said, ``Well, I haven't
paid.'' ``Well, you are covered.'' That was in Italy.
Mr. COHEN. And does the United States not have one of the greatest
discrepancies of wealth between the richest and the poorest in the
industrialized world as well? So are we saying to our wealthy people,
``You can afford health insurance so you can get it,'' but for those
people who are poor, ``Too bad''?
Mr. GARAMENDI. The other countries of the world don't look at it that
way. They look at it as a right for their citizens to have access to
health care, and they provide the health insurance. There are different
ways of doing it. Germany, France, Britain, Canada all do it
differently, but they all do it.
Incidentally, the health statistics in all of those countries are
considerably better than America, and America is placed at the bottom
of the industrialized countries in terms of our health care, how
healthy we are, how long we live, how sick we get. We are at the
bottom. In fact, we are often with developing countries in the
statistics. We spend almost twice as much as any of those other
countries.
So the Affordable Health Care Act goes after many, many things beyond
the Patients Bill of Rights and the senior issues. Thank you so very
much for raising that issue.
We have about maybe 10 more minutes. Mr. Pallone.
Mr. PALLONE. Well, I just wanted to talk a little bit about
prevention, and particularly in terms of seniors, which you mentioned,
and what it means in terms of people's health and also the cost to the
government, because some of the things that we've mentioned with regard
to seniors have already taken place.
This summer under the bill, seniors who fell into the doughnut hole
got a $250 rebate. Beginning January 1, they get a 50 percent discount
on brand-name drugs if they fall into the doughnut hole in 2011.
You mentioned the copays for preventative care, whether it's your
annual wellness treatment or other kinds of tests like mammograms or
colonoscopies, for example. The reason that we are eliminating the 20
percent copay for these things, the reason we are trying to fill up the
doughnut hole, it all goes back to prevention. Because if people get
their drugs and they don't end up getting sick and going to the
hospital, if they get these tests or they have the annual wellness
checks, they stay healthy, they don't go to the hospital. And when they
go to the hospital, if they are on Medicare, it just costs the
government more money.
So this is the way we save money. We save money. And what does that
mean? It means that the debt is decreased. It means that the solvency
of Medicare you have on the chart is extended.
I don't know if we have talked much about that. One of my amendments
in

[[Page H88]]

the Rules Committee today is--a lot of seniors tell me, they come up to
me and say they are worried about the fact that Medicare may become
insolvent and there wouldn't be enough money in the trust fund to pay
for it. The bottom line is that the health care reform bill extends the
judgment day, if you will, when the solvency problem becomes an issue
much further. And if you have the repeal, the solvency problem hits us
6 years from now, in 2017, from what I understand.
So another problem with repeal is not only does it increase the
deficit, but it also is only 6 years from now that we would have to
deal with this Medicare solvency problem. And what is that going to
mean? That is going to mean probably cutbacks in benefits for senior
citizens. Because if you don't have the money, you are going to have to
cut back on the benefits. It is amazing to me how they can continue to
talk about this repeal.
The other thing they keep saying on the other side of the aisle, the
Republicans say, well, the reason we want the repeal is because this
health care reform is killing jobs. Nothing could be further from the
truth.

{time} 1630

The fact of the matter is that under this health care reform because
the cost of health care premiums for employers will be significantly
reduced, they will be able to hire more people. Part of the problem
that we have with competition with other countries, you mentioned all
these other countries, all these other industrial countries that have
free health care, universal health care. That means that the employers
don't carry the burden of that. So when they hire someone if the
government is paying for it, they don't have to worry about that for
their employees necessarily. If the cost of premiums go down, then the
costs of hiring somebody goes down in the United States.
In addition to that, there are all kinds of jobs created in the
health care professions because, as everyone gets covered and everybody
needs a primary care doctor, you're going to need more doctors, more
nurses, more health aides because people will get that kind of
preventative care. So there are jobs created with the preventative care
in handling people, to make sure they stay healthy or they stay well.
It is unbelievable to me when they talk about repeal. What the
Republicans should be doing is spending the first few days of this
session talking about how to improve the economy and create jobs, not
repealing health care. I think the American people have moved on. They
don't want to hear this. They want to know what this Congress is going
to do to create jobs and improve the economy. We've already dealt with
the health care issue and they want us to move on.
Mr. GARAMENDI. We have about, maybe 3 minutes, 4 minutes, and I am
going to turn now to the gentleman from Tennessee (Mr. Cohen).
Mr. COHEN. I just wanted to add one thing. Thank you.
The gentleman from New Jersey brought up an issue, and he said that
it was not true that it was costing jobs. There is some respected
group, I think it's called FactCheck. They were on national news giving
the biggest lies told in politics in the last year. The number one
biggest lie--this independent group--was the Republican mantra of
government run or government mandated health care. It's just a fact.
That's the biggest lie told the American public. And it came from the
leaders on the other side, it came from these halls where they are
immune from defamation suits. Because it's not government run health
care. It's unheard of, unfathomable, that the other side would use the
fact that they're immune from prosecution in any other jurisdiction or
court for words that aren't true to do that and in politics to say it
was government run health care, the biggest lie of 2010, and it comes
to the floor next week.
Mr. GARAMENDI. We are going to wrap this one up. I see the gentleman
from Kentucky is here and he will probably carry on with health
insurance. Maybe a couple of us will be asked to join him.
We have really today focused on a broad range of issues: The
patients' bill of rights; the way in which the repeal would harm
individuals who have preexisting conditions; young children from
infancy; the 23- to 26-year-old coverage.
We also discussed a little bit about how this affects business and,
of course, we went into some detail about senior citizens. All of these
are critically important issues. We will be discussing these in the
days ahead. I do hope the American public will really pay attention,
because this next week, particularly as we move towards Wednesday, is
going to be absolutely critical to the American people. It's a question
about will all of us in America be able to get health care coverage
that is affordable and provides us with the opportunity to have the
health care that we need.
Mr. Speaker, I yield back the balance of my time.

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